Evaluation of Madigan Procedure in the Treatment of Habitual Dislocation of Patella

This was a clinical trial (quasi experimental) study carried outat the National Institute of Traumatology and OrthopedicRehabilitation (NITOR), Dhaka, between July 2004 to June2006, involving 16 patients with habitual dislocation of thepatella. All these cases were managed by Madigan operativeprocedure. Aim of this study was to evaluate the effectivenessof the madigan procedure in the treatment of habitualdislocation of the patella. Out of these 16 patients 2 weresubsequently lost from follow up. So, the study finally consistedof 14 patients. In this study non-random purposive techniqueas per inclusion and exclusion criteria was followed irrespectiveof sex. Most common age group in this study was 6-10 years(62.5%). The mean age of occurrence was 8.25 years.Repeated intramuscular injection on the thigh was thecommonest cause of dislocation found in 37.5% cases. Thesecond most common cause of dislocation was history of boil.Abscess or cellulitis on the thigh followed by contracture of thequadriceps muscles. Various postoperative complications likehypertrophic scar constituted (18.75%), stitch granuloma(6.25%), restriction of knee motion (6.25%) and re-dislocationoccurred in (6.25%) cases. Functional outcome in themanagement of habitual dislocation of the patella wasanalyzed by using the Hospital for Special Surgery (HSS) kneescore. Regarding the final or overall results in this series, therewere 71.43% cases were found satisfactory and the remaining28-57% were found unsatisfactory result.

Lateral Structure Release for the Treatment of Mild to Moderate Habitual Dislocation of Patella: A Retrospective Study / 中国运动医学杂志

Objectives To evaluate the clinical outcome of lateral structure release in the treatment of patients with mild or moderate habitual dislocation of patella(HDP).Methods From 51 HDP patients undergoing surgical treatment between April 2010 and 2014,23 patients were chosen and given the lateral structure release,including isolated lateral retinaculum release (LRR) and LRR combined with vastus lateralis oblique(VLO) lengthening.Other auxiliary surgeries included medial patellofemoral ligament(MPFL) reconstruction and tibial tubercle medialization.Radiological,objective and subjective evaluations were performed at 4 and 8 weeks,as well as and 1 year after the surgery and every year afterwards.Results There were 21 patients followed for a minimum of 2 years.Their average age was 25.0 + 7.4 years (ranging from 17 to 38 years old),and the mean follow-up period was 30.5 ± 5.8months(ranging from 24 to 36 months).Isolated LRR was performed in 42.9％(9/21) of the patients,and LRR combined with VLO lengthening was performed in 57.1％(12/21) of them.No redislocation was reported.Significant improvement was observed in the subjective evaluation score.Conclusions For patients with mild to moderate HDP,lateral structure release can achieve satisfactory results.

Ultra-thin Rigid diagnostic and therapeutic arthroscopy during arthrocentesis: Development and preliminary clinical findings / 대한악안면성형재건외과학회지

Arthroscopy is useful to detect early changes in the temporomandibular joint (TMJ). Despite great advances in arthroscopy, many arthroscopic surgeries have now been replaced by arthrocentesis. We propose a simple diagnostic and therapeutic method having operative rigid ultra-thin arthroscopy with 16 gauge needle size combined with arthrocentesis.

The "Four-in-One" Procedure for Habitual Patellar Dislocation in Children with Formation Failure of Femoral Trochlea and Generalized Ligamentous Laxity : A Preliminary Report / 대한정형외과학회잡지

Purpose: To evaluate the clinical results of a "Four-in-One" procedure for a habitual dislocation of the patella in children with generalized ligamentous laxity and formation failure of the femoral trochlea. Materials and Methods: Five knees in 4 patients were included in this study. The average age of the patients at the time of surgery was 5.9 years and the subjects were followed up for an average of 41.6 months postoperatively. The clinical results were evaluated using the criteria of the Kujala's scoring system as well as a physical examination and radiological findings. Results: During the follow-up period, there were no recurrent dislocations, knee joint pain, limitations of motion or gait disturbances in any of the cases. The mean Kujala score was 96.8. Two cases had complications related to wound healing but they healed eventually. Conclusion: The "Four-in-One" procedure, which include the lateral retinacular release, medial vector augmentation, semitendinosus tenodesis, and patellar tendon transfer is recommended for a habitual dislocation of the patella in children with generalized ligament laxity and formation failure of the femoral trochlea.

Modified Elmslie-Trillat Operation in Recurrent and Habitual Patella Dislocation

PURPOSE: To evaluate the effectiveness of the modified Elmslie-Trillat operation on recurrent and habitual patella dislocation. MATERIALS AND METHODS: From November 1993 to December 2000, 16 cases of modified Elmslie-Tril-lat operation were performed in 13 patients. Recurrent dislocation were 10 cases, habitual were 6 cases. Mean age was 26 years old(15~46) and male was 1 patient, female were 12 patients. We checked the Q angle and congruence angle to compare the postoperative state with the preoperative result by radiologic finding. Crosby and Insall's criteria was used to evaluate the clinical results. RESULTS: The congruence angle and Q angle were improved from average 46 degrees (10 degrees ~ 77 degrees) and 20.2 degrees(16 degrees ~35 degrees) in preoperative state to average -5 degrees (-10 degrees ~4 degrees) and 9.5 degrees(4 degrees~15 degrees) in postoperative state. Patella alta were 2 cases and patella baja was none in preoperative measurement. There was no change of patella alta in postoperative measurement. In Crosby and Insall 's criteria, 5 cases showed excellent, 10 cases good, l case poor result. At final follow-up, there were no postoperative complications such as degeneratve arthritis, nonunion, ROM limitation except 1 case of patellar redislocation. CONCLUSION: Modified Elmslie-Trillat operation is good alternatives to the recurrent and habitual patella dislocation.